Skip to main content

Advertisement

Log in

Pseudotumor due to metallosis after total elbow arthroplasty

  • Case Report
  • Published:
Indian Journal of Orthopaedics Aims and scope Submit manuscript

Abstract

The incidence of primary total elbow arthroplasty (TEA) in young patients is increasing. The indications for revision surgery are also rising. Here, we report a rare case of pseudotumor detected in a patient 16 years after TEA. Intraoperative findings revealed a necrotic mass characterized by a conspicuous metallosis in the soft tissues around the prosthesis, which caused ulnar nerve dislocation. Due to this anatomical change, a lesion of the nerve was accidentally produced during revision surgery. The case report emphasizes that the indications for elbow replacement, as well as the patient education about the permanent physical limitations, should be carefully considered. Moreover, the high risks of complications related to the revision procedure and pseudotumor removal need to be addressed before surgery. The technique should be done carefully and a preliminary thorough imaging should be performed, since a newly formed mass can cause significant distortion of the anatomy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Cooney WP, Morrey BF. Elbow arthroplasty: historical perspective and emerging concepts. In: Morrey BF, Sanchez Sotelo J, editors. The Elbow and its Disorders. Philadelphia: W.B. Saunders; 2009. p. 705–19.

  2. Voloshin I, Schippert DW, Kakar S, Kaye EK, Morrey BF. Complications of total elbow replacement: A systematic review. J Shoulder Elbow Surg 2011;20:158–68.

    Article  Google Scholar 

  3. Kim JM, Mudgal CS, Konopka JF, Jupiter JB. Complications of total elbow arthroplasty. J Am Acad Orthop Surg 2011;19:328–39.

    Article  Google Scholar 

  4. Throckmorton T, Zarkadas P, Sanchez-Sotelo J, Morrey B. Failure patterns after linked semiconstrained total elbow arthroplasty for posttraumatic arthritis. J Bone Joint Surg Am 2010;92:1432–41.

    Article  Google Scholar 

  5. Krenek L, Farng E, Zingmond D, SooHoo NF. Complication and revision rates following total elbow arthroplasty. J Hand Surg Am 2011;36:68–73.

    Article  Google Scholar 

  6. Loebenberg MI, Adams R, O‘Driscoll SW, Morrey BF. Impaction grafting in revision total elbow arthroplasty. J Bone Joint Surg Am 2005;87:99–106.

    Article  Google Scholar 

  7. Kosy JD, Walter RP, Conboy VB, Blake SM. Use of a femoral impaction grafting system in revision total elbow arthroplasty. Ann R Coll Surg Engl 2011;93:416–7.

    Article  CAS  Google Scholar 

  8. Sanchez-Sotelo J. Total elbow arthroplasty. Open Orthop J 2011;5:115–23.

    Article  Google Scholar 

  9. Sneftrup SB, Jensen SL, Johannsen HV, Søjbjerg JO. Revision of failed total elbow arthroplasty with use of a linked implant. J Bone Joint Surg Br 2006;88:78–83.

    Article  CAS  Google Scholar 

  10. van der Lugt JC, Rozing PM. Outcome of revision surgery for failed primary Souter-Strathclyde total elbow prosthesis. J Shoulder Elbow Surg 2006;15:208–14.

    Article  Google Scholar 

  11. Shi LL, Zurakowski D, Jones DG, Koris MJ, Thornhill TS. Semiconstrained primary and revision total elbow arthroplasty with use of the Coonrad-Morrey prosthesis. J Bone Joint Surg Am 2007;89:1467–75.

    Article  Google Scholar 

  12. Sayed-Noor AS, Sjödén GO. Severe metallosis after total elbow arthroplasty-A case report. Hand (N Y) 2010;5:86–9.

    Article  Google Scholar 

  13. Glyn-Jones S, Pandit H, Kwon YM, Doll H, Gill HS, Murray DW. Risk factors for inflammatory pseudotumour formation following hip resurfacing. J Bone Joint Surg Br 2009;91:1566–74.

    Article  CAS  Google Scholar 

  14. Gill IP, Webb J, Sloan K, Beaver RJ. Corrosion at the neck-stem junction as a cause of metal ion release and pseudotumour formation. J Bone Joint Surg Br 2012;94:895–900.

    Article  CAS  Google Scholar 

  15. Matthies AK, Skinner JA, Osmani H, Henckel J, Hart AJ. Pseudotumors are common in well positioned low-wearing metal-on-metal hips. Clin Orthop Relat Res 2012;470:1895–906.

    Article  Google Scholar 

  16. Pandit H, Glyn-Jones S, McLardy-Smith P, Gundle R, Whitwell D, Gibbons CL, et al. Pseudotumours associated with metal-on-metal hip resurfacings. J Bone Joint Surg Br 2008;90:847–51.

    Article  CAS  Google Scholar 

  17. Degreef I, Sciot R, De Smet L. Metallosis in revision total elbow arthroplasty. Complications and staging method. Acta Orthop Belg 2008;74:753–60.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Lucia Savarino.

Additional information

This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rotini, R., Bettelli, G., Cavaciocchi, M. et al. Pseudotumor due to metallosis after total elbow arthroplasty. IJOO 51, 103–106 (2017). https://doi.org/10.4103/0019-5413.197557

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.4103/0019-5413.197557

Key words

MeSH terms

Navigation